The recent Melbourne thunderstorm asthma event has led some people to question what made this hay fever season so bad and how this tragic event occurred.

Thunderstorm asthma, a sudden surge in cases of acute respiratory illness coinciding with local thunderstorms, ranges from small events that affect handfuls of people to large-scale epidemics that impact a whole city and severely strain the capacity of emergency services.

Thunderstorm asthma occurs when a complex interaction of meteorological and biological factors affects a group of susceptible individuals.

We don’t yet know the clinical circumstances and allergic sensitivities of those who sought medical care on the night of the recent episode. But, based on similar events in Australia, most will likely have been allergic to grass pollen, in particular rye grass pollen.

MELBOURNE, Australia — Three patients remained critically ill on Thursday, three days after a rare condition known as thunderstorm asthma killed four people and sent hundreds to hospitals in Australia’s second-largest city, an official said.

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Melbourne University botanist Ed Newbigin, who runs Melbourne’s main pollen-counting station, said forecasting such events should be possible.

“Thunderstorms and high pollen levels in the air occur reasonably frequently this time of year, but not all those events result in episodes of thunderstorm asthma,” Newbigin said.

“We can probably figure out what are the requirements for producing thunderstorm asthma and come up with, if not a perfect forecast system, at least a pretty good one,” he said.

The world’s first recorded thunderstorm asthma event occurred in Melbourne in 1987. Similar events have happened in the United States, Canada, Britain and Italy. The last major event in Melbourne was in November 2010.

A review into the emergency service response to Melbourne's asthma thunderstorm will examine at least four deaths linked to the rare phenomenon.The man who runs Melbourne's main pollen counting station thinks it's possible to develop an asthma thunderstorm forecast given useful data exists from previous events.

"We get those conditions of high grass pollen and thunderstorms quite regularly in Melbourne at this time of year but it's not every time that we get thunderstorm asthma," pollen expert Ed Newbigin from Melbourne University told AAP.

Three people remain in critical condition following Melbourne's asthma thunderstorm, which has been linked to at least four deaths so far.

Melbourne hospitals treated more than 8500 patients across Monday night and Tuesday, the health department said on Thursday.

'The thunderstorm asthma event on Monday was a health emergency of unprecedented scale,' a spokesman said in a statement.

Victorian Health Minister Jill Hennessy says senior doctors are amazed there weren't many more deaths given the number of people who suffered cardiac arrest and breathing difficulties during the storm which overwhelmed emergency services and hospitals.

MELBOURNE, Australia — Three patients remained critically ill on Thursday, three days after a rare condition known as thunderstorm asthma killed four people and sent hundreds to hospitals in Australia's second-largest city, an official said.

Doctors were amazed there were not more fatalities given the numbers of people who suffered cardiac arrests and struggled to breathe when a wild thunderstorm struck Melbourne on Monday night, Victoria state Health Minister Jill Hennessy said.

The storm caused rain-sodden ryegrass pollen to explode and disperse over the city, with ruptured particles penetrating deep into lungs. Almost one third of patients who suffered asthma attacks on Monday reported never having asthma before.

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This information is copyright (disclaimer & copyright).Apart from any use as permitted under the Copyright Act 1968, no part maybe reproduced by any process without prior written permission fromthe University of Melbourne, Australia. Requests and inquiries concerning reproduction and rights should be addressed to Associate Professor Ed NewbiginSchool of BioSciences, University of Melbourne. Phone: +61 3 8344 4871.